A recent commentary in this journal 1 questioned the accuracy of ultrasound and argued for the use of menstrual history with some modifications of Nagele’s rule. This would be a regrettable and retrograde step. Recent research has shown conclusively that, where equipment and trained personnel are available, ultrasound is the method of choice for dating pregnancies. We present a review of these findings and put their significance into a clinical context. In comparing the measurement of gestational age by menstrual dates and by ultrasound, one has to look at systematic and random error. In each case, ultrasound performs considerably better. Systematic error states how accurately, on average, the measurement reflects the truth in the sampled population; this is important for definitions and policies based upon them, such as the timing of induction of labour for post-term pregnancy. Nagele’s rule uses the mean length and predicts this to be days 2. Instead, in large enough databases this can be derived from a modal value, found to be days 3. This is the same as that in the study by Bergsjo et al.
Hospital Attracts Patients With Doctor ‘Speed Dating’
Doppler Ultrasound The doppler shift principle has been used for a long time in fetal heart rate detectors. Further developments in doppler ultrasound technology in recent years have enabled a great expansion in its application in Obstetrics, particularly in the area of assessing and monitoring the well-being of the fetus, its progression in the face of intrauterine growth restriction, and the diagnosis of cardiac malformations.
Doppler ultrasound is presently most widely employed in the detection of fetal cardiac pulsations and pulsations in the various fetal blood vessels. The “Doptone” fetal pulse detector is a commonly used handheld device to detect fetal heartbeat using the same doppler principle. Blood flow characteristics in the fetal blood vessels can be assessed with Doppler ‘flow velocity waveforms’.
Diminished flow, particularly in the diastolic phase of a pulse cycle is associated with compromise in the fetus.
Friendswood Women, featuring Dr. Shamburger is an OBGYN practice serving the Friendswood, League City, Clear Lake and Webster areas. OB GYN Doctor serving Women Friendswood, League City, Clear Lake, Webster, Houston Areas.
The standards and guidelines reflect what the AIUM considers the minimum criteria for a complete examination in each area but are not intended to establish a legal standard of care. AIUM-accredited practices are expected to generally follow the standards with the recognition that deviations from the standards and guidelines will be needed in some cases, depending on patient needs and available equipment. Practices are encouraged to go beyond the standards and guidelines to provide additional service and information as needed by their referring physicians and patients.
Recommendations for physician requirements, procedure documentation, and quality control vary among these organizations and are addressed by each separately. This guideline has been developed for use by practitioners performing obstetric sonographic studies. Fetal sonography should be performed only when there is a valid medical reason, and the lowest possible ultrasonic exposure settings should be used to gain the necessary diagnostic information.
A limited examination may be performed in clinical emergencies or for a limited purpose, such as evaluation of fetal or embryonic cardiac activity, fetal position, or amniotic fluid volume. A limited follow-up examination may be appropriate for reevaluation of fetal size or interval growth or to reevaluate abnormalities previously noted if a complete prior examination is on record. While this guideline describes the key elements of standard sonographic examinations in the first trimester and second and third trimesters, a more detailed anatomic examination of the fetus may be necessary in some cases, such as when an abnormality is found or suspected on the standard examination or in pregnancies at high risk for fetal anomalies.
In some cases, other specialized examinations may be necessary as well.
OBGYN DATING THE PREGNANCY IN THE 1ST TRI lecture notes
Sayra met her husband, Paul, in medical school and upon completing their residencies they relocated to Jacksonville where Paul grew up. Paul currently practices gastroenterology with The University of Florida. Sayra and Paul have three children, Ben, Mallorie and Zach who keep them busy at many sporting activities.
Evaluation of clinic and population based intervention to prevent or reduce the impact of dating violence, sexual violence or intimate partner violence. Determining the mental and physical health effect and cost of intimate partner violence.
All six of our Family Birthing Centers offer private, beautiful, comfortable maternity rooms that feel more like home than a hospital. Each room in the ABC offers a birthing tub and birth stools. And at the Family Birthing Center in Baton Rouge, two suites have birthing tubs, and the labor and delivery rooms are twice the size of normal hospital rooms to create the experience of home for mother and baby.
Ochsner obstetricians, nurse midwives, obstetric nurses and lactation specialists will do everything we can to make your birthing experience all that you hope it would be. That includes making sure your baby is with you 23 out of 24 hours of the day, and promoting Skin-to-Skin Care — even after a C-section. Choose Your Team Depending on your situation and the kind of delivery you prefer, you might have a certified nurse midwife, a fellowship-trained obstetrician or a maternal fetal specialist at your side while giving birth.
Some moms-to-be love the idea of a certified nurse midwife — an expert in traditional vaginal birth who has a deep trust in women’s bodies and the birth process. Nurse midwives encourage women and their families to actively participate in their healthcare by providing individualized education, counseling, pre-natal care, labor and delivery and postpartum support.
This is someone who specializes in one thing: Being there for women having babies. Ochsner is the only hospital in Louisiana that offers moms the option of self-administered nitric oxide. This takes the edge off the pain but still allows mothers to experience the wonder of natural childbirth. Along with the doctors, your team will include some of the smartest, warmest and most efficient obstetric nurses in the country.
Endometriosis Staging – The Four Stages of Endometriosis
The Way to a Woman’s Heart: Staying Healthy and Well community conference. The annual event, open to patients, staff and members of the community, focuses on the unique health needs of women at midlife.
There is an awful story circulating on Facebook about a young mother who lost her first child because of her doctor’s negligence. It’s a heartbreaking story because the baby was healthy throughout the pregnancy and the mother made it to full term. However, allegedly, because of the doctor’s poor decisions, the baby died during the delivery.
Kurt Froelich assaulted patients in his office and the hospital. Kurt Froehlich of his license. The first time Froehlich sexually assaulted a patient was in The first time she came to him as a patient, she waited until after the regular gynecological checkup had concluded to ask questions about arousal and her G-spot. Instead of drawing a picture to demonstrate, Froehlich put a glove back on and “just show[ed] her basically where it is.
Froehlich to locate her G-spot when they were working in the hospital. Froehlich acknowledged that he stimulated her to orgasm in a call room of the hospital on that occasion. Froehlich testified that, approximately one week later, he had a sexual encounter with Patient 1 at the hospital where they engaged in sexual intercourse.
Froehlich further testified that they ended the relationship the following day: Froehlich specifies that they did not have sex, but he gave her an orgasm. Somehow, one of the State Medical Board members wanted to give Froehlich a one-year probation before he would be allowed to return to medicine, but the majority voted for revoking his license. According to Froehlich’s website , he “will continue to provide care through the middle of February.
Thursday, May 25, http: Throughout pregnancy decisions like ordering and interpreting lab tests, determining fetal growth and performing intervention to prevent preterm births or post-term pregnancies and associated morbidities are based on accurate dating. Estimated Due Date EDD and current gestational dating should be documented on medical records and discussed with the patient as early as possible based on dates of Last Menstrual Period LMP and earliest available ultrasound in pregnancy.
Many women have irregular cycles, or falsely recall the date of LMP or have irregular ovulation, which is not considered when calculating the EDD by traditional method. The American College of Obstetricians and Gynecologists, the American Institute of Ultrasound in Medicine, and the Society for Maternal—Fetal Medicine make the following recommendations regarding the method for estimating gestational age and due date:
Women for Women is an OBGYN practice in Nassau County, New York.
Obstetrics Our Philosophy At Gwinnett OBGYN Associates we value every patient and strive to take care of our patients during their pregnancy, delivery, and postpartum to the best of our ability. Here you will find a team of highly qualified board-certified physicians and nurse practitioners as well as a large number of staff whose goal is to make every patient feel as comfortable as possible with her care. Our team of providers include 5 physicians and 2 nurse practitioners. When To Call For First Appointment We like for our patients to call us as soon as they find they are pregnant to schedule the first prenatal visit.
The prenatal care visits normally start at around 7 weeks gestation about 3 weeks after a missed period. To help with the flow of your first appointment, please download and complete the new patient OB forms and bring to your first appointment along with your insurance card and a photo ID. Please arrive 30 minutes before your first appointment. Blood tests are done next. The visit usually ends with meeting with our financial advisor to discuss any financial concerns or questions you might have.
Ask The OB’s Wife!
Prior to the 18th century, caring for pregnant women in Europe was confined exclusively to women, and rigorously excluded men. The expectant mother would invite close female friends and family members to her home to keep her company. The presence of physicians and surgeons was very rare and only occurred once a serious complication had taken place and the midwife had exhausted all measures to manage the complication.
Calling a surgeon was very much a last resort and having men deliver women in this era whatsoever was seen as offending female modesty.
Eliza Berkley and Alfred Abuhamad, Sonographic Dating and Standard Fetal Biometry, Queenan’s Management of High‐Risk Pregnancy, (), (). Wiley Online Library. Shane Reeves and .
Monday, February 27, courtesy: ACOG has always strived to curb elective deliveries before 39 weeks of pregnancy and spread awareness among obstetricians about the negative effects of elective delivery before 39 weeks, which increases neonatal respiratory and nonrespiratory morbidities. As the woman advances into second and third trimester the reliability of USG for the purpose of dating decreases linearly.
The guidelines for management are: The decision about timing the delivery in a suboptimally dated pregnancy should be based on the best clinical estimate of the gestational age. There is no role for elective delivery in suboptimally dated pregnancies to avoid the neonatal morbidity because the pregnancy may be earlier in gestation than believed to be.
Decision to administer antenatal corticosteroids should be based on the best clinical judgement if a woman with suboptimally dated pregnancy is identified to be at risk for preterm delivery. A follow-up sonography after weeks of the initial one is always advisable in women with suboptimally dated pregnancies. It helps to support the prediction of gestational dating as well as fetal well-being in terms of weight gain.
It is always difficult to manage a presumably late-term pregnancy that lacks accurate dating because of the risk of overlooking post maturity and associated fetal morbidity and mortality. Therefore, is advised to begin antepartum fetal surveillance at 39—40 weeks of gestation and to deliver at 41 weeks using the best clinical judgement because it could be more postdated than it is believed to be.
In women with suboptimally dated pregnancy with a previous history of low transverse C-section incision a trial of labor can be given based on the clinical assessment of gestational age.
This product is not intended to diagnose, treat, cure or prevent any disease. Your experience with Amberen will be unique as well. Statistically significant results typically occurred between 30 through 90 days of continuous use. Amberen is not intended for use by pregnant or nursing women. Do not take if you have severe hypertension.
If you are taking prescription medication or have any medical condition, consult your doctor before use.
Share Tweet Different Stages of Endometriosis If you suspect that you may have endometriosis, it is important that you consult with your doctor and receive an accurate diagnosis. Endometriosis is commonly diagnosed via pelvic exam or a surgical procedure called laparoscopy. As part of the diagnosis, the doctor will typically determine which stage of endo [ ].
If you have a vagina , do you want to see someone who also has a vagina? When I started asking cis women about their experiences with male gynecologists, I was largely expecting most of them to say they preferred to see a woman. Some did, of course. K has been seeing her male GYN for over 10 years. J planned to give birth to her second child via C-section , and on the advice of her midwife, switched from her care to that of a physician.
The midwife recommended a male OB, which surprised J since she would not have made that choice herself, but went with it because she trusted her midwife and because the female staff of the practice were less available. At the end of the surgery, he held my hand and looked me right in the eye and said something to me that was really touching.
I have no recollection of what he said, just how he made me feel, and I was so grateful! I am so grateful [for] that doctor who was empathetic, gentle and so helpful. I continued seeing him until I moved far away for graduate school, scheduling appointments on trips home from college and my first job.
Becoming an Ob/Gyn
We assist patients with ovulation disorders, endometriosis, polycystic ovarian syndrome PCOS , fiboid tumors, unexplained infertility, recurrent miscarriages, and other conditions related to fertility problems. We initiated our office based screening Mammography practice in as an extension of our care for patients. Our mammography unit is located at our Sydney Curve building, next door to our main office on Taylor Road. Most of these births are in hospitals.
Visit RateMDs for information on Dr. Pamela K Smekrud in Crystal Lake. Get contact info, maps, medical practice history, affiliated hospitals & more.
Visualize the entire cervix. If a heavy vaginal discharge is present, remove it carefully without disturbing the epithelium. Obtain the portio ectocervix sample first, then obtain the endocervical sample. This will minimize the blood in the sample. Small amounts of blood will not interfere with cytologic evaluation, but large amounts will.
We do not perform pap smears during menses for this reason Avoid contaminating the pap smear with lubricant – we always do a pap smear and all cultures before a bimanual examination. Either is appropriate in most cases. Cytobrush can increase the yield of obtaining endocervical cells by seven-fold. Use these if available.